Title: Lexicon Development in Collaborative Care: A pre-empirical foundation for a national agenda of empirical study Project Summary Abstract Research regarding better collaboration between mental health and primary care clinicians is globally positive-but does not identify specifically what components or functions lead to those positive results when they occur. A national research agenda is forming to answer that question. But the field of "collaborative care" is still developing-and does not yet have a widely accepted and consistently understood lexicon (system of terms and concepts) with which to ask research questions (or articulate a national research agenda). Removing confusion over language in this field-a major impediment to practice-based comparative effectiveness research-is the central aim of this proposal. Consistently understood language and concepts are in place in all mature scientific fields, including electrical engineering, physics, and software development-and are the pre-empirical basis for doing good empirical science. AHRQ has recently invested in advancing and creating knowledge on the integration of mental health and primary care, e.g., The 2008 AHRQ EPC report on integration of mental health and primary care, the 2009 AHRQ-sponsored conference to create a national research agenda, and the 2010 AHRQ Academy for Integrating Mental Health and Primary Care. These investments will need to be protected by creating a consistent, consensus-based set of concepts and terms for asking research questions. The proposed conference brings members of the National Integration Academy Council together to create such a consensus lexicon. The published methodology, "paradigm case formulation" and "parametric analysis", lead to a set of interrelated concepts (like an extended definition) for comparing practices or asking research questions using a common vocabulary. This will build on a well-regarded (but limited) "pilot" lexicon created for the AHRQ-sponsored 2009 research agenda conference. This method has also been used to clarify language in palliative care, shared decision-making and patient- centered medical home. In addition to creating the lexicon, conference participants will identify important research and practice development applications for this lexicon, begin to facilitate its use in those projects and in the AHRQ Academy, and identify a line of inquiry to create validated lexicon-based tools for comparing and contrasting different kinds of collaborative care practices for purposes of comparative effectiveness research. PUBLIC HEALTH RELEVANCE: Project Narrative Research is needed to discover specifically what features of collaboration between mental health and primary care clinicians lead to positive outcomes for health, patient experience and affordability of healthcare. But this research will require a much more consistent and widely accepted system of terms and concepts than presently exists. Otherwise, confusion over language among researchers, practices and research funding organizations will continue to take place. The proposed conference will bring to maturity a previous "pilot" lexicon that proved useful for research in this field.